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A 48-year-old Asian male, presented to the hospital for an elective total thyroidectomy in the context of 6.3 cm thyroid nodule. The fine needle aspiration cytology of the nodule confirmed papillary thyroid cancer (PTC) with some atypical histiocytes. He has a history of idiopathic arginine vasopressin deficiency (AVP-D) and has been taking oral DDAVP 100 μg daily, self-adjusting the dose based on thirst and polyuria. Additionally, he also has a history of recurrent spontaneous pneumothorax. His total thyroidectomy was aborted due to significant intraoperative bleeding, and his admission was further complicated by post-operative hyponatraemic seizure. Thyroid histology revealed the diagnosis of Langerhans cell histiocytosis (LCH), and further investigation with contrast CT demonstrated multi-organ involvement of the thyroid, lungs, and bones.

The tasking of the Indian Navy has increased manifolds in the recent past due to the country's growing economic importance, increasing energy requirements, and expanding trade routes. As operational elements of the blue water Navy, Indian Naval ships and submarines are deployed far and wide for prolonged durations. Therefore, for ships and submarines to be able to operate far away from our coasts, a comprehensive afloat medical care system needs to be developed with the capability to provide need-based secondary (specialist) and tertiary (superspecialist) care to men at sea. Telemedicine is envisaged to provide the solution to medical care needs of personnel onboard ships/submarines and in remote islands/locations and support unhindered Naval operations in peace and combat scenario. Telemedicine is a genuine force multiplier; it will not only complement the present medical support and extend expertise to areas bereft of the same but will also be helpful in prolonged operations and extended deployments by providing specialist/superspecialist consultation to the men at sea. In today's world of advanced telecommunication, telemedicine is a perfect amalgamation of communication technology and medical science, which is bound to revolutionize the field of Combat Medical Care by improving both clinical outcomes and operational efficiency of the Indian Navy. The article reviews telemedicine concept, its components, utility in the provision of specialized medical care to men at sea and its limitations.

Data on 1,28,075 artificial inseminations (AI) performed during 6 years (January 2010 to November 2015) on 1,02,386 field animals owned by 55,685 farmers’ from 69 cattle development centres spread across four districts of Bihar were collected and analyzed. Whole data set was classified according to districts (Chhapra, Samastipur, Siwan, Vaishali), economic status of farmers (APL, BPL), animal breed (HF cross, Indigenous, Jersey cross, Nondescript), lactation order/parity of animal (heifer, first, second, third, fourth, fifth, sixth and above), animal body condition score (all ribs exposed, no rib exposed, one rib exposed, two ribs exposed, three ribs exposed), heat stage (early, mid, late), season of AI (rainy-June to September, winter-October to January, summer-February to May) and sire used for AI (Gir, HF purebreed, HF crossbreed, Jersey purebred, Jersey crossbreed, Sahiwal). Logistic regression analysis was used to compute the odds ratio and probability of conception rate. The results revealed that overall mean conception rate as 52.16% and it was noticed significantly higher in Chhapra district, BPL group of farmers, Jersey crossbreed animals, animals having third lactation, animals exhibiting three ribs exposed, mid heat and animals inseminated with HF purebred semen compared with respective groups of parameters under study. However, effect of season of AI did not affect conception rate in rural animals under field conditions of Bihar. ACKNOWLEDGEMENT Authors are very much grateful to the President, BAIF for his encouragement. Financial support from Department of Animal Husbandry, Government of Bihar and help rendered by Godhan project team for data compilation is gratefully acknowledged

Standardization of anaesthetic equipment is needed for safe anaesthetic practice. Various organizations and regulatory bodies have been made throughout world to formulate and control standards for anaesthesia equipment including endotracheal tubes. All endotracheal tubes must conform to ASTM standards. This has medico-legal importance also. Regulatory bodies should look after the whole process right from the manufacturers to the actual users. The Indian Society of Anaesthesiologists promotes safe anaesthetic practice, by establishing purchase guide-lines for equipments and drugs. It is working in collaboration with World Federation of Societies of Anaesthesiologists. Standards have made anaesthesia and critical care equipment much safer over the years. There is need to form standards for various equipment in India.

Abstract

The objective was to assess the soil fertility and quality status and its influence on crop yield in tribal area of central India. Soil samples and yield data were collected from 780 farmers' fields across the region and analyzed. Soil quality index was calculated adopting a simple minimum dataset of indicators including intrinsic and dynamic soil properties. Further for comparison across the region, relative soil quality index (RSQI) and relative crop yield (RY) parameters were calculated. Soils in the region mostly had clayey (30.8%) and sandy loam (27.4%) texture with neutral to alkaline pH. The soils deficient in organic carbon, available N, P, K, S, Zn and Fe was 57.1%, 83.3%, 37.2%, 3.4%, 68.3%, 18.6% and 4.1%, respectively. More than 40% of soils were at least deficient in three nutrient elements. The soil quality was also poor (69% soils) and moderately poor (21%) categories with RSQI less than 70%. The soil indicators responsible for poor soil quality were shallow soil depth, poor organic C and microbial activity, and deficiency of N, S, P and Zn. The relationship between RY and RSQI was developed using linear regression model resulted in RY= 0.92×RSQI + 9.66 R²=0.33 and was highly positive. This indicated that soil in the study area had poor soil fertility and quality status, and appropriate soil test based balanced integrated nutrient management practices along with soil and water conservative practices in shallow depth hilly terrain soils could restore or enhance the soil quality and improve the crop yield in the region. [ABSTRACT FROM AUTHOR]